1073784468 NPI number — DR. SHIKHA KHOSLA MD

Table of content: DR. SHIKHA KHOSLA MD (NPI 1073784468)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073784468 NPI number — DR. SHIKHA KHOSLA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHOSLA
Provider First Name:
SHIKHA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073784468
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
VETERANS AFFAIRS MEDICAL CTR
Provider Second Line Business Mailing Address:
50 IRVING STREET NW . SUITE GE246
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20422-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-745-8300
Provider Business Mailing Address Fax Number:
202-745-8303

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VETERANS AFFAIRS MEDICAL CTR
Provider Second Line Business Practice Location Address:
50 IRVING STREET NW . SUITE GE246
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20422-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-745-8300
Provider Business Practice Location Address Fax Number:
202-745-8303
Provider Enumeration Date:
03/13/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  D0058322 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 375550900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 61727303 . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: G4810005 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".